Professional Documents
Culture Documents
Chapter 18: Durable and Nondurable Medical Equipment, Devices, and Supplies
Chapter 18: Durable and Nondurable Medical Equipment, Devices, and Supplies
Learning Outcomes
Describe durable & nondurable medical equipment
Identify types of blood glucose meters & systems
Describe steps in measuring blood glucose
Describe nondurable medical supplies used in
insulin delivery
blood glucose monitoring
Learning Outcomes
Identify various types of blood pressure
Key Terms
Aneroid blood pressure monitor
CLIA-waived
Colostomy
Continuous subcutaneous insulin infusion
Control solution
Durable medical equipment
Hemoglobin A1c
Insulin pen
Lancet
Key Terms
Nondurable medical equipment
Orthotic
Orthopedic devices
Orthotic devices
Ostomy
Pedometer
Stoma
Test strip
Urostomy
DME
Durable Medical
Equipment
that are
able to withstand repeated use
primarily used to serve medical purpose
generally not useful to person without
illness/injury
appropriate for use in the home
Role of Pharmacy
Technician
Assists pharmacist in
maintaining adequate supplies & equipment
billing insurance for these items
CLIA
Clinical Laboratory Improvement
laboratory requirements
heart disease
stroke
blindness
kidney failure
nerve damage
amputations
Glucometers
Measure whole blood glucose
Vary in features
size of blood sample needed for testing
calibration
testing time
memory of test results
audible blood glucose meters
Lancets
BG Monitoring Process
1. Gather materials used for test
2. Wash hands or clean finger/area of skin to be
3.
4.
5.
6.
7.
used
Place test strip in meter/obtain test strip from
meter
Lance (stick) area of skin to obtain blood sample
Apply blood sample to test strip
Record blood glucose reading in log book
Discard lancet in hard, puncture-resistant
container
Insulin Delivery
Insulin is hormone produced in pancreas
promotes utilization of glucose
synthesis of protein
formation & storage of lipids
Different types of insulin vary in their
onsets
peaks
durations of action
Name of insulin
Type of Action
Rapid-Acting
Rapid-Acting
Rapid-Acting
Short-Acting
IntermediateActing
Long-Acting
Long-Acting
Insulin
Injected with or before meals or administered once
daily
Concentration most commonly used 100 units/mL
Available in 3-mL or 10-mL sizes
Insulin injected subcutaneously (under skin)
Traditionally, insulin administered using syringe
can also be administered with insulin pens
continuous infusion using pump
hip/buttocks
injected
allows for more accurate dosing
units
4. Inject air into insulin vial
5. Invert vial, withdraw units, check for air
bubbles while syringe needle remains in vial
Insulin Pens
Portable, discreet, convenient
Components: cartridge, dose indicator, dose knob
Cartridges are available in 1.5-mL or 3-mL sizes for
refill
Some are disposable pens
discard entire device no refills
Insulin pens continue to be updated with newer models
Disadvantages of Insulin
Pens
Typically more expensive
Limited to commercially available products
Each injection is limited to maximum number
Sharps Disposal
Insulin syringes/pen needles should be used
once
Discarded into puncture-resistant container
Products available for sharps disposal
BD Home Sharps Container
BD Safe-Clip
Clip & Stor Insulin Needle Safety System
UltiCare
UltiGuard
Voyager.24-26
Continuous SQ Insulin
Infusion
Provided via catheter
attached to insulin reservoir within insulin pump
physical activity
Frequent blood glucose monitoring required
Advantages of Insulin
Pump
Elimination of individual insulin injections
More accurate insulin delivery than injections
Improvement of hemoglobin A1c level
Fewer variations in blood glucose
Disadvantages of Insulin
Pump
Weight gain
Diabetic ketoacidosis (DKA)
Expense
Device attached to body at all times
Extensive education required
Infection resulting from improper care
Pump Features
Basal rates, battery life, degree of water
resistance
Pump provides both basal & bolus delivery
Daily dose:
4050% for basal
5060% for bolus insulin
monitoring
Blood Pressure
Monitoring
Hypertension (high blood pressure) major risk
factor for:
heart disease
stroke
congestive heart failure
kidney disease
Hypertension management
monitoring blood pressure
Blood Pressure
Home blood pressure monitoring
Adjustments in lifestyle and/or medication
therapy
Blood pressure measured in millimeters of
mercury (mmHg)
Normal blood pressure is considered to be
<120/80 mmHg.
High blood pressure for adults is defined as
systolic blood pressure of 140 mmHg or higher or
diastolic blood pressure of 90 mmHg or higher
heart rates
accuracy affected by the size of cuff used
Monitoring Process
1. Avoid food, caffeine, tobacco, alcohol for 30
2.
3.
4.
5.
6.
7.
8.
minutes
Sit quietly for 35 minutes in comfortable position
Rest your arm, at level of your heart, on table
Place arm cuff over brachial artery
Measure blood pressure by following directions
Remain quiet while taking your blood pressure
Write measurements down in your own log
Take repeat reading 23 minutes after 1st one to
check accuracy
active
Normal heart rate ranges for adults, 60100 beats
per min
Heart beat detected radio signal transmitted
Regular physical activity can
improve blood glucose control
reduce cardiovascular risk factors
contribute to weight loss
improve well-being
Pedometers
Records each step-detects motion of the hips
Recommended number of steps per day- 10,000
Microelectromechanical system (MEMS)
inertial sensors & sophisticated software
Pedometer should be worn on belt
Simplest pedometers-only count steps
Complex pedometers
calorie estimates, clocks, timers, stopwatches,
Measuring Cholesterol
High cholesterol-modifiable risk factor for heart
disease
60% of all adults have high cholesterol
(>200mg/dL)
> 1 of every 5 adults have > 240 mg/dL
Home testing of cholesterol
determine health risk status for heart disease
fingerstick
Results within 1015 minutes
Measuring Hemoglobin
A1c
Average blood glucose control for past 23
months
Patients may want to monitor their hemoglobin
A1c levels between physician visits
Blood sample obtained from fingertip using
lancet
Samples must be mailed to reference laboratory
Results are sent back to the patient by mail, by
fax, or electronically
HIV Testing
Rate of HIV in US rapidly increasing
21% undiagnosed & unaware of their HIV
status
Body forms antibodies to virus between 6
weeks & 3 months after infection with HIV
virus
HIV test in privacy of home
concern for maintaining confidentiality
results are retrieved by calling toll-free number
kit is considered to be 99.9% accurate
Pregnancy/Ovulation
Testing
Home pregnancy test
use drop of urine on test strip
detects human chorionic gonadotropin (hCG)
positive result-color change or symbol appears
false-negative results if tests very early in
pregnancy
Orthopedic Devices
Orthopedic devices are DME
used by patients of all ages
braces, supports, splints
used for rehabilitation & pain management
Orthotic devices
prevent or correct physical deformity or
malfunction
Ostomy Products
Ostomy is a surgically created opening in
body
Sigmoid or descending colostomy
most common type of ostomy surgery
certain types of cancer of bowel or anus
Stoma
passage through abdominal wall
Other -ostomies
Ileostomy
involves small intestine
ileoanal reservoir (also known as J-Pouch)
Urostomy
diverts urine from bladder
reservoir or pouch in abdomen
pouch systems include